submit no more than 250-300 words essay in APA format, a journal entry that summarized the practicum activities located in the attached file in the file area.

9/9/2019

08:00-12:00 Today, my preceptor and I continued to attend various meeting regarding the newly implemented electronic health record (EHRs) system. We met with the representatives of Epic EHRs to discuss all the tickets that were created since the Go-Live which had not yet been resolved, and to come up with a plan to fix all the remaining issues that had been encountered.

12:00-17:00 We also met with the Periop to discuss the issue they have with the patients’ dropping off the big board when they go to surgery. When patients go to surgery, they are dropping off the big board. Also, to investigate and troubleshoot the issues the nurses are having with the documentation of the preop checklist and the exited assessment disappearing from the system without being saved.

9/11/2019

8:00-12:00 Today, my preceptor and I attended a meeting regarding the center for Medicare and Medicaid services (CMS) survey. During the all-day long meeting, we went over the HCAHPS Domains which included the nurse communication, doctor communication, responsiveness and hospital staff.

12:00-17:00 My preceptor and I participated in the second part of the meeting regarding the CMS. We discuss the cleanliness and quietness of the hospital environment, pain management, communication about medications, discharge information, overall rating, care transitions and likelihood to recommend the hospital.

9/12/2019

08:00-12:00 Today, my preceptor and I participated in a meeting with the representatives of the intensive care unit (ICU) and the hospital IT department to discuss the issue with the Heparin order not requiring a dual sign in so that it should be related to Epic members to include a dual sign in for Heparin when changing the rate from the MAR. Also, the issue of the Heparin not communicating from MAR to flowsheet. The issue of important drips missing from the MAR such as “Agratroban and Magnesium.

09/16/19

08:00 – 12:00 I attended a meeting with my preceptor regarding updating care plans for the labor and delivery unit. Also, a conference on old policies that are still showing in the hospital new electronic health system epic: “They don’t want nurses to see the old policies so that they don’t refer to the old policies.”

12:00 – 17:00 My preceptor and I attended a meeting with the laboratory manager Karen to discuss the specimens’ collection. Karen audit the specimen collection data and the nursing informatics sends it out. The hospital had to switch from Mobilab specimen collection to the Epic specimens’ collection. Unfortunately, the epic system is limited, and nurses now have to revert to two nurses sign off for specimens’ collection as labels no longer print at the patient bedside

09/17/19

08:00 – 12:00 My preceptor and I attended a meeting with the intravenous (IV) therapy team regarding how they document PICC insertion. The staff is having issues with the documentation of the PICC line insertion as the flow sheet is not built in properly.

12:00 – 17:00 My preceptor and I continued the meeting with the IV therapy, and we were all also joined by two members of informatic technology (IT) team. The IV therapy team expressed their concerns about the fact that the Picc line insertion flowsheet was not allowing them to document patient consent to Picc which is a must. The different areas where the PICC line could be inserted as well as whether the Picc is single, double or triple lumen were also discussed. At the conclusion of the meeting, all parties agreed on how to construct a better flowsheet by the IT team, which would allow for better documentation of PICC lines insertion.

09/19/19

08:00 – 12:00 My preceptor and I attended an Epic super-user refresher course. The facility recently transitioned to a new and better electronic health record system (EHRs).

12:00 – 14:00 My preceptor and I attended a patient education meeting on the quality of the devices since the implementation of the Epic EHRs.

14:00 – 17:00 My preceptor and I met with the vice president of the hospital along with the director of nursing informatics and the vice president’ secretary to discuss readiness for the Epic EHR Go-live date.

09/23/19

08:00 – 12:00 My preceptor and I participated in a meeting with IT team as well as all the unit manager to make sure all the scanning system are working properly since the Go-live date of the new Epic EHRs.

12:00 – 17:00 My preceptor and I as well as different members of the facility spent the rest of the afternoon helping the IT team matching the open tickets that have been opened since the Go-live date by the various units of the facility to the right problem.

09/24/19

08:00 – 12:00 My preceptor and I attended the monthly Nursing Quality Council meeting to discuss the various issues that have now arise since the implementation of the new EPIC EHRs Go-live date.

12:00 – 17:00 My preceptor and I attended a weekly meeting for the Epic super-users to discuss and troubleshoot some of the problems they have come across on the units since the implementation of the Epic electronic health records system.

09/26/19

08:00 – 12:00 Today, I assisted my preceptor in helping out members of the Informatics Department as well as other available staff members of the facility in matching all the tickets numbers of all the issues that have arisen since the implementation of the Epic to the right problem.

12:00 – 17:00 In the afternoon, my preceptor and I met with the pharmacy team to discuss some of the problems related to intravenous (IV) medications doses that were not correctly displaying in the new Epic EHR system.

09/30/19

08:00 -12:00 My preceptor and I attended a meeting with the facility’ vice president . The facility’ vice president had requested an updated report from my preceptor listing all the issues that had arisen since the Go-live date of the new Epic EHRs. She expected the report to not only show the unresolved issues but the resolved issues as well. During the meeting, she expressed her frustration on the lack of the organization of the Epic Go-live issues report and expected a new and better organized report by the next morning to present it to the representatives of Epic so that they could resolve the issues that the facility new system is currently facing.

12:00 – 15:00 My preceptor and I headed to meet with the IT department team to discuss all of the expectations of the facility’ vice president for the updated report of the issues she requested.

15:00 – 17:00 My preceptor and I had a conference with Dr. wright, the facility’ medical director. During the meeting, we discussed the various issues that the doctors have encountered since the Go-live date so that we could bring them to the IT department to troubleshoot and find a solution.

10/01/19

08:00 – 10:00 My preceptor and I attended a “Director” meeting. The focus of this monthly Directors’ meeting was to discuss current issues from the new Epic EHRs implementation and how to resolve them.

10:00 – 12:00 I assisted my preceptor with an Epic training class for the hospital’ newly hired nurses.

12:00 -17:00 My preceptor and I continued to teach the Epic training course to the newly hired nurses throughout the rest of the afternoon.

10/03/19

08:00 -12:00 My preceptor and I, as well as the IT department team and the facility’ various unit managers met with the vendors of the Epic EHRs standardized nursing care plans called L-Severe. During the meeting, we discussed some of the important missing components that the vendor (L-Severe) of these standardized hadn’t included in the systems. Each unit manager brought in their input on what they felt needed to be added to the standardized nursing care plans for the patients.

12:00 -17:00 For the afternoon, my preceptor and I continued with the meetings with the vendor (L-Severe) of the new standardized nursing care plans and the remaining unit managers that hadn’t brought in their inputs yet.

10/07/19

08:00 – 12:00 Today, I assisted my preceptor with a class for the newly hired nurses’ Cohort 11 Residency Program. I helped my preceptor with handing out the required forms to the nurses for them to fill out and also by helping them locating the required literature review for the PICO question that was given out to each group for the practice evidence-based practice (EBP) project was assigned to them.

12:00 – 17:00 I continued to assist my preceptor with the Cohort 11 newly hired nurses’ residency program. This afternoon we focused on the newly implemented EPIC EHRs system.

10/08/19

08:00 -12:00 Today, my preceptor and I participated in the monthly Nursing Council Practice meeting. This morning, we reviewed and revised some of the facility’ policies and procedures as well as some standards of care. We also discussed how to improve incorporating evidence-based practice research findings into clinical practice as well as consulting on interdepartmental issues that impact patient care and to recognize achievements in the facility’ nursing practice.

12:00 – 17:00 This afternoon we continued with the Nursing Practice Council. We discussed moments of excellence for this month amongst the nursing staff and praised each of them for their accomplishment. We also discussed how to promote the active, exciting and innovative sharing of ideas, group work, computer use, library use, and consulting in our facility as well as with other institutions and professional organizations. We also discussed maintaining the Magnet initiatives as they relate to evidence-based practice and shared governance.

10/10/19

08:00-12:00 This morning, my preceptor and I attended the Patients’ Perspectives of Care Survey-Centers for Medicare and Medicaid services (HCAHPS) meeting in preparation for their visit to our facility. During the meeting we discussed the communication with nurses, communication with doctors, staff responsiveness and communication about medicines.

12:00 – 17: 00 In the afternoon section of the HCAHPS meeting, we discussed the discharge information and the care transition which covered how well patients understand the type of care they need after leaving the hospital as well as the hospital’ cleanliness and quietness.